Thyroid Cancer Coverage from Every Angle
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Glucose Metabolism: A Prognostic Marker in Thyroid Cancer?

By: Celeste L. Dixon
Posted: Thursday, March 12, 2020

The possible association between increased glucose metabolism and differentiation in thyroid cancer has been relatively unexplored, according to research published in BMC Cancer. Generally, well-differentiated cancers have a better prognosis than their poorly differentiated counterparts, but a key finding of the team’s work is that even in well-differentiated tumors, a high glycolysis signature can predict poorer prognosis. Senior author Keon Wook Kang, MD, PhD, of Seoul National University Hospital in Korea, and colleagues suggest that risk stratification could be clarified in the future by using dual-time FDG-PET to estimate glycolysis activity and that a particular tumor subtype with enhanced glycolysis and high differentiation may exist.

Focusing on RNA sequencing and clinical outcomes of 505 patients with papillary thyroid cancer, Dr. Kang and co-investigators found that glycolytic activity and glucose transporter (GLUT) signature were differently associated with tumor differentiation score (calculated by 16 genes related to thyroid functions). “In papillary thyroid cancer, the glycolysis signature was positively correlated with tumor differentiation score, while the GLUT signature was inversely correlated with tumor differentiation score,” they noted. The correlations appeared to be significantly stronger in BRAF V600E–negative versus BRAF V600E–positive patients.  

“Meanwhile, both GLUT and glycolysis signatures were negatively correlated with tumor differentiation score in advanced thyroid cancer,” explained the authors. Also, “cancer cellular GLUT expression was negatively associated with tumor differentiation in both papillary thyroid cancer and poorly differentiated thyroid cancer/anaplastic thyroid cancer.” More research is needed, but Dr. Kang and colleagues hypothesized that a “‘U-shape’ pattern for the association of…differentiation and glycolysis” could exist.

Disclosure: The study authors reported no conflicts of interest.

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